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Recent Publications

“Medical Practices Lack Solid Scientific Support”

Sep 13, 2020

In September of 2020, shocking headlines stated, “Only 1 in 10 medical treatments is backed by high-quality evidence.” Most believe that the treatments prescribed by their doctors are supported by high-quality scientific studies but that is far from being true. An analysis in the Journal of Clinical Epidemiology, concluded that only 9.9 percent of recommended treatments had high-quality evidence according to the gold-standard method for determining whether they provide high or low-quality evidence, called GRADE (grading of recommendations, assessment, development and evaluation). Using the same system, 37 percent had moderate, 31 percent had low, and 22 percent had very low-quality evidence. Lack of high-quality evidence, according to GRADE, means that future studies might overturn the results. Studies that are “blinded” – in which patients don’t know whether they are getting the actual treatment or a placebo – offer higher-quality evidence than “unblinded” studies. Blinding is important because people who know what treatment they are getting can experience greater placebo effects than those who do not know what treatment they are getting. Many poor-quality trials are being published. It is estimated that there are currently 25 thousand medical/scientific journals turning out over one million publications annually. It is also estimated that 50% of these papers have reached the wrong conclusions. The tsunami of trials published every year, combined with the need to publish in order to survive in academia, has led to a great deal of rubbish being published.

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“Dementia Review 2020”

Sep 06, 2020

With the current presidential campaigns in full swing, the subject of dementia has been raised as it relates to both candidates. A little review is in order. As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is called normal memory loss and is part of the expected changes with aging. When you have troubles with memory – but they don’t interfere with your daily activities – this is called mild cognitive impairment. Your doctor might recommend the MoCA, or Montreal Cognitive Assessment test, which screens for memory problems and helps determine if more evaluation is needed. Dementia tends to be a slow-moving progression that occurs over months or years. Depression can also cause memory changes, particularly as we get older. Alzheimer’s dementia is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or an inability to do calculations like balance the checkbook. And, as with any disease or disease group, dementia is not a “character flaw,” and the term should not be used to criticize a person. Dementia is a serious medical diagnosis. Approximately 6 million Americans have dementia and nearly a half-million new Alzheimer’s cases will be diagnosed annually. Dementia, which is not technically a disease but a term for impaired ability to think, remember or make decisions, is one of the most feared impairments of old age. About 5% of those aged 71 to 79 have dementia, and about 37% of those about 90 years old live with it.

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“Concussion Risks and Terry Bradshaw”

Aug 30, 2020

With the return of football season, we need to have an increased awareness of the dangers of concussions. People who sustain a concussion may be at increased risk for a wide range of neurological and psychological conditions later in life. A new study reveals that people with a concussion diagnosis are more likely to develop mood and anxiety disorders, dementia, and Parkinson’s disease than individuals in the control group. In 2011, Hall of Fame quarterback, Terry Bradshaw said he is feeling the effects of numerous concussions sustained during his NFL career. The 62-year-old Shreveport native said he has been having short-term memory loss as well as the loss of hand-eye coordination. Bradshaw told KTBS-TV that he sustained at least six concussions, plus an unknown number of instances where there was a blow to the head that would require him to “clear the cobwebs.” Bradshaw penned a deal with CBS Sports soon after his retirement to become an NFL analyst and is currently the co-host of Fox NFL Sunday. He has an estimated net worth of $15 million. Terry Bradshaw also has clinical depression, diagnosed in 1999. He takes medication to properly balance the serotonin in his brain.

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“Dementia Drugs Require Caution”

Aug 23, 2020

A new study reports that nearly three-quarters of older adults with dementia have filled prescriptions for medicines that act on their brain and nervous system but aren’t designed for dementia. That’s despite the potentially harmful risks that such drugs carry for older adults and the lack of evidence that they actually ease the dementia-related behavior problems that often prompt a doctor’s prescription in patients with Alzheimer’s disease and related disorders. In fact, some of the drugs have been linked to a worsening of cognitive symptoms in old adults. The study was published in the journal JAMA and based on data from 737,839 people with dementia and was the first large-scale study of prescription-filling patterns for psychoactive medications outside of nursing homes and other long-term care facilities. Nearly half of those in the study received an antidepressant, which might be prescribed to try to counteract the withdrawal and apathy often seen in dementia, but antidepressants don’t treat this aspect of dementia. Even so, the study shows antidepressant prescribing at nearly triple the rate for older adults overall. The new study suggests a need to reduce prescribing to people in nursing homes and those living at home with dementia, too. In all, 73.5% of the study’s community-based population filled at least one prescription for an antidepressant, opioid painkiller, epilepsy drug, anxiety medication, or antipsychotic drug in a one-year period.

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“Viral Infections May Last A Lifetime”

Aug 09, 2020

Many viral infections may linger and “hideout” in your body after you have seemingly recovered from the initial infection. Currently, millions are recovering from COVID-19 infections and we do not know to what extent this virus can linger on in your body. When viruses linger around, they may lead to additional spreading of the disease and prolonged symptoms. A chronic or persistent infection continues for months or years, during which time the virus is being continually produced, albeit in many cases at low levels. Frequently, these infections occur in a so-called immune-privileged site, where it is less accessible to the immune system and the body has difficulty in trying to eradicate it. Such immune-privileged sites include the central nervous system (brain), the testes, and the eye. A latent infection occurs when the virus is present within an infected cell but dormant and not multiplying. The latent virus may integrate into the human genome – as does HIV. A latent virus can reactivate and produce infectious viruses, and this can occur months to decades after the initial infection. The best example of this is chickenpox, which although seemingly eradicated by the immune system can reactivate and cause herpes zoster (shingles) decades later.

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“Sugar and Hyperactivity in Children is a Myth”

Aug 02, 2020

The prevailing notion is that when children indulge in sugary foods, they turn feral and nearly uncontrollably bounce off the walls. Most parents really believe that sugar causes hyperactivity in their children. But scientific investigations do not support this assertion. Reportedly, scarfing down bowls of candy does not launch offspring into sugar-induced bedlam. In 1995, JAMA published a meta-analysis that combed through the findings of 23 experiments across 16 scientific papers. Surprisingly, the authors concluded: “This meta-analysis of the reported studies to date found that sugar (mainly sucrose) does not affect the behavior or cognitive performance of children.” But the authors noted that they cannot eliminate the possibility of a “small effect.” However, overall, the scientists demonstrated that there certainly is not an effect as large as many parents’ report. Still, some parents believe that their child is particularly sensitive to sugar. Investigators tested this notion and concluded, “For the children described as sugar-sensitive, there were no significant differences among the three diets in any of 39 behavioral and cognitive variables. For preschool children, only 4 of the 31 measures differed significantly among the three diets, and there was no consistent pattern in the differences that were observed.” In 2017, a related study appeared in the International Journal of Food Sciences and Nutrition. The researchers investigated the impact of sugar consumption on the sleep and behavior of 287 children aged 8–12.

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“COVID-19 Can Cause Prolonged Fatigue in Mild Cases”

Jul 21, 2020

We have seen a spike of COVID-19 in our area but fortunately it appears to be of a mild variety. Many patients report mild headaches, muscle aches and low-grade fever. They seem to recover in a few days, but some are experiencing severe fatigue, which can last for long periods. Overwhelming fatigue, palpitations, muscle aches, pins and needles, and many more symptoms are being reported as after-effects of the virus. Around 10 percent of the 3.9 million people contributing to the COVID-19 Symptom study app have effects lasting more than four weeks. If one percent of the 290,000 or so people who have had COVID-19 in the UK remain under the weather at three months, this will mean thousands of people are unable to return to work. They will probably have complex needs that the NHS is ill-prepared to address. Chronic fatigue – classified as fatigue lasting more than six weeks – is recognized in many different clinical settings, from cancer treatment to inflammatory arthritis. It can be disabling. COVID-19 is not the only cause of chronic fatigue. Prolonged fatigue is well recognized after other viral infections such as the Epstein-Barr virus, which causes infectious mononucleosis (also known as glandular fever). Treating chronic fatigue is difficult and frequently ineffective.

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“Is Dining Out Too Risky”

Jul 13, 2020

One of the more common pleasures has been dining out. However, the COVID-19 pandemic has created a cloud over the safety of eating out. Even sitting down at a Cracker Barrel without fear of dying would be nice right about now. But can you do so without risk? And should you? Most of the data says that dining out is really risky and should be done so with caution, if at all. Even outdoor dining is considered risky as it also requires social distancing. You certainly cannot eat with a mask on and we are now told that this is a key component to curtail the spread of the virus. If we can believe it, a recent Proceedings of the National Academy of Sciences of the Unites States of America (PNAS) study showed that while social distancing is effective, social distancing combined with mask-wearing is even better. Researchers concluded that “wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic.”

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“Exercise Can Worsen Many Conditions”

Jul 07, 2020

Even though exercise has a wide array of health benefits, there are times when it is contraindicated. Although the benefits of exercise outweigh the risks, injuries are extremely common. You may have been told to “walk it off” if you were hurt on the field or on the court. If you happen to get hurt, the most important thing to do is stop exercising or playing sports and seek treatment. Continued exercising can exacerbate any potential pathology resulting from the initial injury. Injuries can occur due to poor training, improper gear, poor physical fitness, or failure to adequately warm-up.  Eighteen percent of adults reported having an athletic-related injury in the past year.

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“Headaches Linked to Anxiety”

Jul 05, 2020

Today we are faced with a multitude of anxiety triggering situations, from the COVID -19 pandemic to the lockdown of entire countries to racial protests and domestic terrorism. Little wonder we have frequent headaches. Anxiety and headaches are both common, and many people experience them from time to time. According to the National Alliance on Mental Illness, more than 40 million adults in the United States have an anxiety disorder. People with anxiety disorders may have symptoms that interfere with their sleep, relationships, physical health, work or school activities, and everyday life. Scientists are exploring the link between anxiety and headaches. The American Migraine Foundation has reported that 20% of people with episodic migraine and 30–50% of those with chronic migraine have anxiety. A 2016 study found that children with anxiety were likely to have more headaches than children without anxiety. The researchers also concluded that anxiety symptoms were more severe among the children who experienced headaches. Along with the emotional symptoms of tension and dread, anxiety can cause physical symptoms, such as sweating, a rapid heartbeat, digestive problems, and headaches. Headaches can be both a symptom and a cause of anxiety. The most common form of headache is called a tension headache.

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